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Baby Steps

Baby Steps

When I started working as a pediatrician 24 years ago, the only place to find current breastfeeding rates in the United States was from a pharmaceutical company who manufactured infant formula. They tracked breastfeeding rates to follow their “Market Share.” Physicians received visits from formula representatives (“reps”) bringing pens and coffee mugs and post-it pads promoting formula. Many offices got lunch and a little teaching about the latest formula as well. Maybe they mentioned that “breast is best” as part of their talk. (Unfortunately, there is no such human “rep” for breastfeeding. Just hard scientific data.)

Most physicians did not learn about breastfeeding as part of their medical education and many do not feel they have the time to learn about it later. But they do know a lot about formula. And formula reps bring cases of free formula to their office to make it even easier for a physician to endorse a particular brand by handing it to a parent. I know, because 20 years ago I was such a pediatrician.

The American Academy of Pediatrics (AAP) has received a LOT of funding from formula manufacturers over the years. They have a large annual meeting, and for years the name tag lanyards of every participant have advertised a brand of formula. Lectures during the conference about breastfeeding have been listed as being sponsored by formula manufacturers. Printing of “educational materials” about breastfeeding developed by unpaid AAP members have been paid for by formula manufacturers, who prominently placed their brand names on the booklets.

The leadership of AAP has been approached many times in the past by the “breastfeeding section” of the AAP (those of us who pay a few extra dollars to belong to an AAP committee wanting to promote and support breastfeeding and assist in policy statements) about this conflict of interest. These concerns were generally ignored. I finally found this all so disheartening that I refused to pay dues to the AAP for over ten years.

But this week I received word that the current president of AAP recently met with members of the breastfeeding section and agreed that it is NOT appropriate to allow the formula manufacturers to advertise on the conference lanyards or sponsor presentations or written materials pertaining to breastfeeding! Formula companies may have a booth at the conference like any other company interested in advertising to pediatricians, but they may not appear to be endorsed more than anyone else. This is a huge baby step forward!

I want to make it clear that I know we DO need an alternative to feed babies who need it. Formula is not evil. It is the best we can do at the moment if a baby cannot have human milk. But formula manufacturers are major corporations who are primarily concerned with profits, NOT the health of mothers and babies. And they currently ARE allowed to influence the physicians who exist to help mothers, infants and children be as healthy as they can be. This is simply not acceptable. And while we work towards not allowing ANY formula company advertising, to anyone, we also need to work toward a day when there is plenty of human milk available for ALL of our babies…but that is a topic for another day.